Provider Demographics
NPI:1285891044
Name:SAIGON PHARMACY LLC
Entity type:Organization
Organization Name:SAIGON PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RPH
Authorized Official - Prefix:
Authorized Official - First Name:THUY DIEM
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHRMD
Authorized Official - Phone:713-478-1641
Mailing Address - Street 1:12002 VETERANS MEMORIAL DR
Mailing Address - Street 2:STE C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-1161
Mailing Address - Country:US
Mailing Address - Phone:281-631-0600
Mailing Address - Fax:281-631-0602
Practice Address - Street 1:12002 VETERANS MEMORIAL DR
Practice Address - Street 2:STE C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-1161
Practice Address - Country:US
Practice Address - Phone:281-631-0600
Practice Address - Fax:281-631-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX260043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145928Medicaid
2101293OtherPK
4548294OtherNCPDP PROVIDER IDENTIFICATION NUMBER